Prevention and early intervention protocols for schools

Prevention and early intervention services play a critical role in supporting student mental health by addressing concerns early, strengthening protective factors and reducing the likelihood that challenges will escalate. In Ontario schools, these services are grounded in research, tailored for the school context and delivered by trained school mental health professionals as part of a tiered system of support.

What the research tells us

•  Structured psychotherapy, an approach to mental health intervention that is systematic, short-term and evidence-based, has been shown to be a responsive and cost-effective approach to supporting individuals with mental health disorders.
• Schools are an important setting for structured psychotherapy, broadening the workforce beyond costly clinical settings.
• A stepped care approach, where least-intrusive, low-intensity interventions are tried first and more intensive supports are added as needed, offers a helpful entry point for young people who require mental health support.
• Brief Intervention for School Clinicians (BRISC), a cornerstone protocol for school mental health professionals in Ontario that was adapted for use with a team from University of Washington, has been shown to produce positive outcomes in as little as four sessions, and is seen as feasible and acceptable to clinicians.
• Likewise, Brief Digital Interventions, now known as Brief Coping Interventions (BCIs), adapted for Ontario by a team from Harvard University and McMaster University, were shown to improve outcomes for participating Ontario students in fewer than three sessions.

Why this is important

Early evidence-based interventions help students develop skills to manage stress, emotions and challenges before difficulties escalate or interfere with learning and well-being. Providing these supports in schools increases access, reduces barriers to care and supports earlier identification of emerging mental health concerns.

Using evidence-informed protocols helps students receive consistent high-quality support while allowing flexibility to tailor interventions to individual strengths, identities and circumstances. A stepped care approach also helps schools use resources effectively by offering the right support at the right time.

About brief interventions available for schools

These brief strength-based supports have been selected for use and scale-up within Ontario through partnerships and study in the Innovation and Scale-Up Lab. Each protocol has been carefully curated for use in the province through a process of research, review and adaptation, alongside international research teams, local field testing and implementation/scale-up support.

A growing suite of protocols has been introduced in Ontario. These protocols broadly follow a ‘stepped care’ continuum, from lower- to higher-intensity programming, to facilitate the selection of right-sized supports for each student.

Protocols include support for measurement-based care, and many have progress-monitoring tools built into the programming to support session-to-session course correction and better outcomes overall.

They are designed to be offered within a therapeutic relationship and delivered in an identity-affirming, culturally responsive manner. School mental health professionals can learn about identity-affirming practices and can access tools to support their practice (e.g., cultural humility tool).

Examples of prevention and early intervention protocols

Examples of protocols currently available in Ontario include:

Lower-to-moderate-intensity supports

• ACT for School – a *new* protocol that adapts Acceptance and Commitment Therapy for the school setting, highlighting key techniques and metaphors set out in eight modules that the clinician can draw from to customize the intervention for each student.
• Brief Coping Interventions (BCIs) – practical single-session modules to help students build daily coping and problem-solving strategies, drawing on common elements of effective clinical interventions.
• Brief Intervention for School Clinicians (BRISC)– a flexibly structured four-session protocol that includes a collaborative problem-solving focus supported by psychoeducation, cognitive restructuring, stress and mood management strategies and communication skill development.
• Cognitive Behavioural Therapy (CBT) for School-based settings  – Professional learning focuses on practical school-based CBT strategies that help students understand the relationship between thoughts, emotions and actions. Training emphasizes brief goal-directed interventions appropriate for mild to moderate concerns. 
• PreVenture– a two-session prevention program for youth aged 12-18 that uses personality-focused interventions to promote mental health and reduce the risk of substance use through the development of goal-setting, decision-making and coping skills.

Protocols for specific populations

• Supporting Transition Resilience of Newcomer Groups (STRONG)– a ten-session group intervention supporting newcomer students in managing stress and change.
• Let’s Talk the Talk – a six-session Africentric program developed by AMANI at CAMH and currently being field-tested in selected communities in collaboration with School Mental Health Ontario.

These interventions are provided by regulated school mental health professionals. Training and implementation support is provided through School Mental Health Ontario.

Access the learning and training calendar for dates and connect with your board Mental Health Leader to register.